SYSTEM AND METHOD FOR DYNAMICALLY ADJUSTING PATIENT THERAPY

• US 20130096444A1
• Filed: 12/04/2012
• Published: 04/18/2013
• Est. Priority Date: 08/25/2004
• Status: Active Grant

• Current Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Original Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Inventors: CRASS, Richard, CONDURSO, Joseph, PAIT, Clifton, VANDERVEEN, Timothy, WEST, Patricia, MORLING, Simon, YAMAGA, Cynthia, BUTTERFIELD, Robert
• Granted Patent: US 8,630,722 B2
• Time in Patent Office: Days
• US Class Current: 600/485
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3576 with non implanted data transmission devices, e.g. using external transmitter or receiver
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 5/172 electrical or electronic A61M5/16804, A61M5/16831 take precedence
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 70/00 ICT specially adapted for the handling or processing of medical references
• CPC Class Codes: G16H 70/40 : relating to drugs, e.g. their side effects or intended usage
• CPC Class Codes: G16H 70/60 : relating to pathologies

Abstract

A system and method of managing therapy provided to patients in an institution. The system monitors all aspects of the medication delivery to a patient, as well as other information related to the patient, such as values of vital signs, laboratory results and patient factors such as history, diagnosis, allergies and the like. The system includes one or more databases of information, including institutionally developed rules, guidelines and protocol representing the best medical practices of the institution. The system provides alerts and/or recommendations based on the application of the rules to the information being monitored, and alerts care givers accordingly, providing for dynamic adjustment of the patient'"'"'s therapy. The system also monitors the status of the alerts, and if no action is taken in a selected period of time, may escalate the priority of the alert and/or halt the delivery of medication to the patient until the alert is resolved.

Claims

1. A system for managing therapy provided to a patient, comprising:

a memory comprising;

a pharmacodynamic (PD) model configured to predict a physiological response based on a concentration of a medication in the patient'"'"'s body tissues; and

at least one limit for the physiological response; and

a processor coupled to the memory, the processor configured to;

receive a measured medication concentration of the medication within at least a portion of the patient'"'"'s body tissue and a measured physiological response of the patient;

retrieve the PD model and the at least one limit from the memory;

utilize the PD model with the measured medication concentration to calculate a predicted physiological response of the patient; and

provide an alert if a difference between the predicted physiological response and the measured physiological response is outside the at least one limit.

2. The system of claim 1, wherein the processor is further configured to provide an alert if the measured physiological response has not been received within a specified time frame since receipt of an immediately prior measured physiological response.

3. The system of claim 1, wherein the processor is further configured to provide a recommendation for adjusting a rate of medication delivery to achieve a desired change in the physiological response.

4. The system of claim 1, wherein the processor is further configured to provide a recommendation for adjusting a rate of medication delivery to achieve a desired target physiological response.

5. The system of claim 1, further comprising a two-way communication system coupled between the memory and the processor.

6. A system for managing therapy provided to a patient, comprising:

a memory comprising a pharmacokinetic (PK) model configured to predict a concentration of a medication within at least a portion of the patient'"'"'s body tissue; and

a processor coupled to the memory, the processor configured to;

accept a medication identification, a treatment protocol, and patient-specific information;

retrieve the PK model from the memory; and

generate, using the PK model, the medication identification, the treatment protocol, and the patient-specific information, at least one of a recommended dosing schedule and a recommended monitoring schedule for administration of the medication to the patient.

7. The system of claim 6, wherein the patient-specific information comprises at least one of the group of an age, a weight, a gender, a diagnosis, a blood pressure, a result of a blood test, and a result of a urine test.

8. The system of claim 6, wherein the dosing schedule comprises a bolus dose and a subsequent continuous rate of administration to achieve and maintain a target concentration.

9. The system of claim 6, further comprising at least one monitoring device configured to measure a concentration of a medication within at least a portion of the patient'"'"'s body tissue and provide information related to the measured concentration of the medication, wherein the processor is further configured to:

accept the information generated by the at least one monitoring device; and

generate, based on the information from the at least one monitoring device, a recommendation for adjusting at least one of the dosing schedule and the monitoring schedule.

10. The system of claim 6, further comprising a two-way communication system coupled between the memory and the processor.

11. A method of managing therapy provided to a patient, comprising the steps of:

receiving a measured medication concentration of a medication within at least a portion of a patient'"'"'s body tissue and a measured physiological response of the patient;

retrieving a pharmacodynamic (PD) model and at least one limit for the physiological response from a memory, the PD model being configured to predict a physiological response based on a concentration of a medication in a patient'"'"'s body tissues;

calculating a predicted physiological response of the patient automatically utilizing the PD model with the measured medication concentration; and

providing an alert automatically if a difference between the predicted physiological response and the measured physiological response is outside the at least one limit.

12. The method of claim 11, further comprising the step of providing an alert automatically if the measured physiological response has not been received within a specified time frame since receipt of an immediately prior measured physiological response.

13. The method of claim 11, further comprising the step of providing a recommendation for adjusting a rate of medication delivery to achieve a desired change in the physiological response.

14. The method of claim 11, further comprising the step of providing a recommendation for adjusting a rate of medication delivery to achieve a desired target physiological response.

15. The method of claim 11, wherein the step of retrieving a PD model and at least one limit for the physiological response from a memory comprises retrieving the PD model and the at least one limit for the physiological response through a two-way communication system coupled to the memory.

16. A method of managing therapy provided to a patient, comprising the steps of:

accepting a medication identification, a treatment protocol, and patient-specific information;

retrieving a pharmacokinetic (PK) model from a memory, the PK model configured to predict a concentration of a medication within at least a portion of the patient'"'"'s body tissue; and

generating automatically, using the PK model, the medication identification, the treatment protocol, and the patient-specific information, at least one of a recommended dosing schedule and a recommended monitoring schedule for administration of the medication to the patient.

17. The method of claim 16, wherein the patient-specific information comprises at least one of the group of an age, a weight, a gender, a diagnosis, a blood pressure, a result of a blood test, and a result of a urine test.

18. The method of claim 16, wherein the recommended dosing schedule comprises a bolus dose and a subsequent continuous rate of administration to achieve and maintain a target concentration.

19. The method of claim 16, further comprising the steps of:

measuring the concentration of the medication within at least a portion of the patient'"'"'s body tissue during administration of the medication and providing information related to the concentration of the medication; and

generating automatically, based at least in part on the measured concentration of the medication, a recommendation for adjusting at least one of the dosing schedule and the monitoring schedule.

20. The method of claim 16, wherein the step of retrieving a PK model from a memory comprises retrieving the PK model through a two-way communication system coupled to the memory.